Treating Sports Hernias
Sally Perkins provides a guide to treating sports hernias effectively.
Sports hernias (also called abdominal wall hernias) are an uncommon but painful injury in the groin area, accounting for up to 4% of all hip and groin injuries in elite soccer players. The injury, which affects muscles and other tissues in the groin area) goes by several different names, including athletic pubalgia, Gilmore's groin, slap shot gut, or footballer's groin. The name 'sports hernia' is a misnomer because unlike other hernias, it does not form a visible bulge and does not tend to heal well with rest and other traditional recovery methods. In this article, we highlight the symptoms of a sports hernia and discuss the most recommended treatments for the condition.
Who gets a sports hernia?
This condition is most prevalent in male athletes who take part in repetitive twisting motions - thus, those playing soccer, tennis, football and similar sports may be affected. It occurs when the muscles of the abdomen and groin are weak and a tear results in the tendons, ligaments, or muscles of the inguinal or pelvic floor. Most patients also have weakness or tears in the oblique muscles (especially the external obliques).
Sports hernias typically develop in young males; females are also affected, but much less so, making up only 3 to 15% of all sports hernia referrals. While it is more common among elite athletes, it can also occur in those who do not play a sport. Risk factors for sports hernias include low levels of off-season sports-specific activities.
Symptoms of sports hernias
Sports hernias cause chronic, activity-related pain that is difficult to localise but is above the inguinal ligament. The pain is dull or burning, radiating towards the scrotum and inner thigh and sometimes crossing midline. Usually, pain gets worse with movements such as stepping sideways, running, and kicking. Sometimes, pain is so severe that athletes cannot continue with their sport of choice.
Treatment of sports hernias
Usually, a non-surgical approach will be tried out, comprising rest, non-steroidal anti-inflammatory medication, physiotherapy, and corticosteroid injections. Usually, doctors will observe the effectiveness of this approach for between six to 12 weeks. Physiotherapy centres on restoring balance and stability to the pubic joint, to improve strength in the trunk region. It is also important to strengthen the adductor muscles since weak muscles in this area coupled with weak abdominal muscles can contribute to the condition. When pain disappears, athletes are usually instructed to go back to their sport. If pain returns, surgery will usually be prescribed.
Surgery for sports hernias
Surgery is a highly efficient approach to the problem; it is normally carried out either with open or laparoscopic techniques, with mean success rates being 92.8% and 96%, respectively. The aim of surgery is to reinforce the posterior wall of the inguinal canal, with or without a mesh. A quicker return to the sport with laparoscopic surgery (one to three months) has been observed compared to open surgery (three to six months), yet there is a higher recurrence rate in laparoscopic surgery (10.1%) than with open surgery using mesh reinforcement (4.9%). The difference has been explained by possible restricted vision when laparoscopic techniques are used.
While the subject of which approach is right in a given situation is a matter for doctors to discuss with patients, surgery is a highly effective way to quell the problem of inguinal hernias, allowing athletes to return to their sports in a relatively small amount of time. If you suffer pain in this area, see your doctor to rule out other possible causes (including stress fractures or bursitis) and try a non-surgical approach first, working to strengthen the abdominal and adductor muscles before considering surgery.
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About the Author
Sally Perkins is a professional freelance writer with many years' experience across many different areas. She made the move to freelancing from a stressful corporate job and loves the work-life balance it offers her. When not at work, Sally enjoys reading, hiking, spending time with her family and travelling as much as possible.
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